Santos, Pedro Alexandre Álvares Bargão dos
Which epigenetic and inflammation related biomarkers can identify clinically aggressive prostate cancer / Pedro Alexandre Álvares Bargão dos Santos ; orient. Rui Henrique... [et al.]
Which epigenetic and inflammation related biomarkers can identify clinically aggressive prostate cancer / Pedro Alexandre Álvares Bargão dos Santos ; orient. Rui Henrique... [et al.] . - Lisboa : NOVA Medical School, 2019 . - 115 p. : il. . -
ABSTRACT: Prostate cancer is a highly prevalent malignancy and a major cause of cancer-related morbidity and mortality. Radical prostatectomy technique remains the major treatment opbon for men with potenbal cure and life expectancy exceeding 10 years. In the very recent 2018 published follow-up of 29 years of SPG4 study (watchful waibng versus radical prostatectomy), men who did RP gained a mean of 2.9 years of life. One of the relevant issues about surgery is its influence in the oncologic prognosis of pabents, namely, the presence of posibve surgical margins and its impact in biochemical recurrence and subsequent treatments. For this reason, we present, in this thesis, a book chapter published in 2015 about the classical open technique with detailed technical specificabons. Nowadays, more and more main urological surgeries are thoroughly robobc. Pabents with biochemical relapse aoer radical prostatectomy are counseled to do salvage radiotherapy directed to prostabc loca and pelvic lymphabc chains, and hormonal therapy within 2 years. In the majority of cases, we do not know if the pabent actually has disease or where it is located. Also, we do not have any independent biomarker that can accurately indicate if the disease will be aggressive and we should treat, or if the tumor is indolent and the pabent can wait safely, without being submiwed to morbid adjuvant treatments. Convenbonally, prostate cancer prognosis evaluabon is mainly based on PSA, surgical margin status, lymph node status, pathological stage and Gleason score. Unfortunately, the prognosbc power of these is, indeed, insufficient. In 2011, we studied the Amadora (Lisbon) Cohort from Hospital Prof. Doutor Fernando Fonseca with 171 pabents, submiwed to retropubic radical prostatectomy between 2000 and 2005. The stabsbcal risk analysis concluded that the presence of PSM in RRP is strongly influenced by pathological stage ≥ pT3a. The presence of PSM and their number increase significantly the risk of BR compared to other factors. In the absence of PSM, the factors that seemed to be crucial and with greater impact on BR were inibal PSA > 10 ng/ml and pathological Gleason score ≥8. The conclusion, thereaoer, and in concordance with evidence, was that it is important to consider inibal PSA pathological Gleason and surgical margins status when making treatment decisions aoer radical prostatectomy. Nowadays, new tools of molecular nuclear imaging are available, namely, 68Ga-PSMAPET/CT, that have accuracy to detect and localize inibal and recurrent disease with very low levels of PSA (≥ 0,2 ng/ml). We are starbng to “see” and to localize prostate cancer. The cons of this nuclear test are probably the costs and the low availability that restricts it to a limited number of cases that can be done per day, especially if no direct access to the generator/reactor is possible. The evolubon of Magne]c Resonance Imaging with its mul]parametric tools, is allowing clinicians to actually visualize the disease, as well. The novel prostate cancer biomarkers, such as liquid biopsies, epigenebc and inflammabon-related biomarkers and its importance are discussed. In this context, we present two manuscripts. The first, an editorial, about a possible novel biomarker and therapeubc target, the Prostate Stem Cell Anbgen (PSCA). The second, a review arbcle about epigenebc and inflammatory biomarkers that is in peer-review in World Journal of Clinical Oncology (WJCO). We think and believe that the genesis and development of prostate cancer is linked to chronic inflamma]on and epigene]c modifica]ons. The new concepts of urinary microbiota and proliferabve inflammatory atrophy (PIA), a prostate cancer precursor, are explained. Owing to the limitabons of current clinical, serologic, and pathologic parameters in predicbng disease inibabon and progression, we sought to invesbgate the prognosbc value of epigenebc and inflammatory biomarkers by immunochemistry on TMA´s of 234 prostabc specimens from two disbnct cohorts: Hospital Professor Doutor Fernando Fonseca in Amadora, Lisbon and Insbtuto Português de Oncologia of Porto. We sought to assess in a retrospecbve way, several biomarkers, namely, prostabc epigenebc biomarkers not so known in prostabc se Prostatic Neoplasms
Therapeutics
Academic Dissertation
Portugal
616
Which epigenetic and inflammation related biomarkers can identify clinically aggressive prostate cancer / Pedro Alexandre Álvares Bargão dos Santos ; orient. Rui Henrique... [et al.] . - Lisboa : NOVA Medical School, 2019 . - 115 p. : il. . -
ABSTRACT: Prostate cancer is a highly prevalent malignancy and a major cause of cancer-related morbidity and mortality. Radical prostatectomy technique remains the major treatment opbon for men with potenbal cure and life expectancy exceeding 10 years. In the very recent 2018 published follow-up of 29 years of SPG4 study (watchful waibng versus radical prostatectomy), men who did RP gained a mean of 2.9 years of life. One of the relevant issues about surgery is its influence in the oncologic prognosis of pabents, namely, the presence of posibve surgical margins and its impact in biochemical recurrence and subsequent treatments. For this reason, we present, in this thesis, a book chapter published in 2015 about the classical open technique with detailed technical specificabons. Nowadays, more and more main urological surgeries are thoroughly robobc. Pabents with biochemical relapse aoer radical prostatectomy are counseled to do salvage radiotherapy directed to prostabc loca and pelvic lymphabc chains, and hormonal therapy within 2 years. In the majority of cases, we do not know if the pabent actually has disease or where it is located. Also, we do not have any independent biomarker that can accurately indicate if the disease will be aggressive and we should treat, or if the tumor is indolent and the pabent can wait safely, without being submiwed to morbid adjuvant treatments. Convenbonally, prostate cancer prognosis evaluabon is mainly based on PSA, surgical margin status, lymph node status, pathological stage and Gleason score. Unfortunately, the prognosbc power of these is, indeed, insufficient. In 2011, we studied the Amadora (Lisbon) Cohort from Hospital Prof. Doutor Fernando Fonseca with 171 pabents, submiwed to retropubic radical prostatectomy between 2000 and 2005. The stabsbcal risk analysis concluded that the presence of PSM in RRP is strongly influenced by pathological stage ≥ pT3a. The presence of PSM and their number increase significantly the risk of BR compared to other factors. In the absence of PSM, the factors that seemed to be crucial and with greater impact on BR were inibal PSA > 10 ng/ml and pathological Gleason score ≥8. The conclusion, thereaoer, and in concordance with evidence, was that it is important to consider inibal PSA pathological Gleason and surgical margins status when making treatment decisions aoer radical prostatectomy. Nowadays, new tools of molecular nuclear imaging are available, namely, 68Ga-PSMAPET/CT, that have accuracy to detect and localize inibal and recurrent disease with very low levels of PSA (≥ 0,2 ng/ml). We are starbng to “see” and to localize prostate cancer. The cons of this nuclear test are probably the costs and the low availability that restricts it to a limited number of cases that can be done per day, especially if no direct access to the generator/reactor is possible. The evolubon of Magne]c Resonance Imaging with its mul]parametric tools, is allowing clinicians to actually visualize the disease, as well. The novel prostate cancer biomarkers, such as liquid biopsies, epigenebc and inflammabon-related biomarkers and its importance are discussed. In this context, we present two manuscripts. The first, an editorial, about a possible novel biomarker and therapeubc target, the Prostate Stem Cell Anbgen (PSCA). The second, a review arbcle about epigenebc and inflammatory biomarkers that is in peer-review in World Journal of Clinical Oncology (WJCO). We think and believe that the genesis and development of prostate cancer is linked to chronic inflamma]on and epigene]c modifica]ons. The new concepts of urinary microbiota and proliferabve inflammatory atrophy (PIA), a prostate cancer precursor, are explained. Owing to the limitabons of current clinical, serologic, and pathologic parameters in predicbng disease inibabon and progression, we sought to invesbgate the prognosbc value of epigenebc and inflammatory biomarkers by immunochemistry on TMA´s of 234 prostabc specimens from two disbnct cohorts: Hospital Professor Doutor Fernando Fonseca in Amadora, Lisbon and Insbtuto Português de Oncologia of Porto. We sought to assess in a retrospecbve way, several biomarkers, namely, prostabc epigenebc biomarkers not so known in prostabc se Prostatic Neoplasms
Therapeutics
Academic Dissertation
Portugal
616
